我院超常处方分析与评价
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[摘要] 目的：分析我院超常处方的基本构成和合理用药情况，为制订有效干预措施提供依据。方法：随机抽取我院2010年1～12月门诊处方3 600张，调查超常处方病种构成和合理用药情况。结果：超常处方数为677张(18.8%)，排序前5位病种分别为糖尿病、胃炎、高血压病、外伤、脑梗死；人均用药品种数为3.07种，针剂使用率为32.9%，抗菌药使用率为36.5%，中成药使用率为51.1%，医保处方比例为25.4%，人均药品费用为304.61元，不合理用药处方数为59张(8.71%)。结论：本院超常处方合理用药水平有待提高并对其进行积极干预。
[关健词] 超常处方；合理用药；处方评价；干预
[中图分类号] R969.3 [文献标识码]C [文章编号]1673-7210(2011)03(b)-131-03
Analysis and evaluation of our hospital's excessive prescriptions
ZHANG Zhuozan, ZOU Aizhen, YU Xiangyun, LIANG Gaoming, PANG Huimin,ZHONG Jianhua
Department of Pharmacy, Longgang District Central Hospital, Guangdong Province, Shenzhen 518116, China)
[Abstract] Objective: To Analysis the basic structure and rational drug use of excessive prescriptions in our hospital, so as to provide the basis for develop effective interventions. Methods: A total 3 600 outpatient prescriptions of our hospital from January to December in 2010 were randomly sampled，and to be investigated disease distribution and rational drug use of excessive prescriptions. Results: The number of excessive prescriptions were 677 (18.8%), the firt five diseases were diabetes, gastritis, hypertension, trauma, cerebral infarction; 3.07 kinds of drugs were used per patient on average; the application ratio of injections was 32.9%, the application ratio of antibiotic was 36.5%, the application ratio of Chinese patent medicine was 51.1%, the rate of medical insurance was 25.4%；the per capita drug cost was 304.61 yuan, the number of unreasonable prescriptions were 59 (8.71%). Conclusion: The rational drug use level of our hospital's excessive prescriptions is still low, which remain to be improved and effective interventions.
[Key words] Excessive prescriptions; Rational use of drugs; Prescription evaluation; Interventions
“看病难、看病贵”是关系民生的社会热点问题，也是决定医疗卫生体制改革成效的重要观察指标。近几十年来，医疗行业的过度市场化导致了“以药养医”、“以药创收”的畸形发展，助长了“大处方”和“收受药品回扣”的不正之风，重创了医院和医生的形象，层出不穷的“医闹”事件反映了当前医患矛盾。大处方的界定各地标准不一，不同经济发展地区，不同疾病，不同治疗手段有不同的判断标准[1]。笔者通过对我院2010年度门诊处方抽样调查，针对费用超常处方(大处方)进行合理性分析，旨在了解超常处方的基本构成和用药合理性，为制订有效干预措施提供依据。
1 资料与方法
1.1 一般资料
2010年1~12月，每月随机抽取门诊处方300张，共3 600张，用EXCEL软件进行录入和分类统计 ......
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